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1.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 130-136, oct.-dic. 2020. graf
Artículo en Español | IBECS | ID: ibc-192959

RESUMEN

OBJETIVO: Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. METODOLOGÍA: Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. RESULTADOS: Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n=18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n=42) y personal de CRG (n=9) dio resultado negativo. CONCLUSIONES: El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida


OBJECTIVE: To describe the measures taken within the COVID-19 contingency plan concerning sentinel lymph node biopsy (SNB) procedures and to assess their impact on healthcare activity. METHODOLOGY: Qualitative, descriptive and retrospective study of SNB procedures conducted during the lockdown period of COVID-19 (14/03 to 11/05 2020). Analysis of measures taken to minimise the chances of contagion and PCR outcomes of patients and staff. Comparison with SNB procedures conducted in the same time interval in 2019. Daily activity of lymphoscintigraphy and radioguided surgery (RGS) by medical indication. Numerical and percentage calculation of RGS by hospital and daily requirements for human resources in nuclear medicine. RESULTS: Forty-two SNB were performed, representing 31.1% less than those conducted in the same period in 2019. The medical indication of breast cancer showed the greatest activity decrease (n=18, 41.9%). RGS was performed in 45.2% of patients in Hospital Clínic, 31.0% in Maternitat, 16.7% in Plató and 7.1% in Sant Joan de Déu Hospital. Concerning the human resources required, the initial planning was accomplished in 77% of the days (24/31). All the PCR samples from patients (n=42) and RGS staff (n=9) were negative for COVID-19. CONCLUSIONS: COVID-19 negatively influenced the healthcare activity of SNB in Hospital Clínic, but was compensated by adequate planning, based on prior analysis of the procedure's processes, which allowed adaptation of material and personnel resources to the changing circumstances. This allowed flexibility, which in turn enabled compliance with the established schedule


Asunto(s)
Humanos , Neoplasias de la Mama/patología , Biopsia del Ganglio Linfático Centinela/estadística & datos numéricos , Infecciones por Coronavirus/prevención & control , Reacción en Cadena de la Polimerasa/estadística & datos numéricos , Cirugía Asistida por Computador/estadística & datos numéricos , Linfocintigrafia/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Precauciones Universales/métodos , Pandemias/estadística & datos numéricos , Biopsia del Ganglio Linfático Centinela/métodos , Estudios Retrospectivos , Servicio de Medicina Nuclear en Hospital/estadística & datos numéricos , Administración de la Seguridad/métodos
2.
Rehabilitación (Madr., Ed. impr.) ; 54(4): 260-268, oct.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-193476

RESUMEN

OBJETIVO: El objetivo de este estudio es analizar el impacto y la organización tanto asistencial como docente en los Servicios de Medicina Física y Rehabilitación de España ante el nuevo y cambiante escenario debido a la pandemia por la COVID-19. MÉTODOS: Se realiza una encuesta dirigida a los tutores de los Servicios de Rehabilitación. Un total de 31 preguntas divididas en 6 apartados: información general de los Servicios, adaptación del Servicio durante el periodo COVID, labor asistencial de los médicos rehabilitadores, abordaje rehabilitador de pacientes COVID, consecuencia de la pandemia sobre la salud de los rehabilitadores y labores de tutoría durante ese periodo. RESULTADOS: Se recibieron un total de 54 encuestas. Casi la mitad de los Servicios cancelaron todas las consultas presenciales (40%) y las salas de terapias se destinaron a camas de pacientes COVID (48%). En 30 hospitales (55,6%) los facultativos han trabajado en plantas COVID. La gran mayoría de los Servicios han elaborado material gráfico y audiovisual con ejercicios, así como protocolos de derivación y tratamiento rehabilitador de pacientes COVID ingresados. Casi la mitad de los Servicios encuestados han tenido algún caso de ansiedad en el personal médico. Las labores de tutoría se han anulado (40,7%) o disminuido (35,2%). CONCLUSIONES: La organización de los Servicios de Rehabilitación para hacer frente a la pandemia ha sido similar en todo el territorio español. La respuesta de los Servicios a la crisis sanitaria ha visualizado la versatilidad de trabajo de los médicos rehabilitadores


OBJECTIVE: The aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic. METHODS: A survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period. RESULTS: A total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%). CONCLUSIONS: The organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians


Asunto(s)
Humanos , Infecciones por Coronavirus/rehabilitación , Medicina Física y Rehabilitación/organización & administración , Virus del SRAS/patogenicidad , Planificación de Instituciones de Salud/organización & administración , Servicios de Rehabilitación , Pandemias/estadística & datos numéricos , Infecciones por Coronavirus/complicaciones , Encuestas de Atención de la Salud/estadística & datos numéricos , Estudios Transversales
3.
Reumatol. clín. (Barc.) ; 16(6): 437-446, nov.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194661

RESUMEN

OBJETIVO: Generar las recomendaciones para la atención de pacientes con enfermedades reumáticas que reciben terapias inmunomoduladoras e inmunosupresoras (fármacos convencionales, biológicos y moléculas pequeñas) durante la pandemia por COVID-19. MATERIALES Y MÉTODOS: Las recomendaciones se realizaron utilizando el método Delphi como herramienta de acuerdo. Se conformó un panel de expertos con trayectoria académica y experiencia en investigación en reumatología. Se realizó la búsqueda de la literatura y se generó el cuestionario del ejercicio Delphi conformado por 42 preguntas. El grado de acuerdo se logró con el 80% de aprobación de los participantes. RESULTADOS: Se conformó un grupo de 11 reumatólogos de 7 ciudades del país. La tasa de respuesta fue del 100% para las 3 rondas de consulta. En la primera ronda se logró acuerdo en 35 preguntas, en la segunda ronda 37 y en la tercera ronda se logró el acuerdo de las 42 preguntas. CONCLUSIÓN: La recomendación para la mayoría de los tratamientos inmunomoduladores utilizados en reumatología es continuar con las terapias en pacientes que no tengan la infección y suspenderlas en aquellos con diagnóstico de SARS-CoV-2/COVID-19


OBJECTIVE: To produce recommendations for patients with rheumatological diseases receiving immunomodulatory and immunosuppressive therapies (conventional drugs, biologicals, and small molecules) during the COVID-19 pandemic. MATERIALS AND METHODS: The recommendations were determined using the Delphi method as an agreement tool. A panel of experts was formed, with academic backgrounds and research experience in rheumatology. A literature search was conducted and 42 questions were generated. The level of agreement was made with 80% of approval by the participants. RESULTS: A group of eleven rheumatologists from 7 cities in the country participated. The response rate was 100% for the three consultation rounds. In the first round, agreement was reached on 35 questions, on 37 in the second round, and on 42 questions in the third round. CONCLUSION: The recommendation for the majority of the pharmacological treatments used in rheumatology is to continue with immunomodulatory or immunosuppressive therapies in patients who do not have the infection, and to suspend it in patients with a diagnosis of SARS-CoV-2/COVID-19


Asunto(s)
Humanos , Enfermedades Reumáticas/tratamiento farmacológico , Factores Inmunológicos/administración & dosificación , Antirreumáticos/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Enfermedades Reumáticas/complicaciones , Pautas de la Práctica en Medicina , Privación de Tratamiento/tendencias , Infecciones por Coronavirus/epidemiología , Pandemias/estadística & datos numéricos
5.
Eur Respir Rev ; 29(158)2020 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-33153991

RESUMEN

The 2019 coronavirus disease (COVID-19) pandemic is caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Clinical outcomes, including mortality, are worse in males, older individuals and patients with comorbidities. COPD patients are included in shielding strategies due to their susceptibility to virus-induced exacerbations, compromised pulmonary function and high prevalence of associated comorbidities. Using evidence from basic science and cohort studies, this review addresses key questions concerning COVID-19 and COPD. First, are there mechanisms by which COPD patients are more susceptible to SARS-CoV-2 infection? Secondly, do inhaled corticosteroids offer protection against COVID-19? And, thirdly, what is the evidence regarding clinical outcomes from COVID-19 in COPD patients? This up-to-date review tackles some of the key issues which have significant impact on the long-term outlook for COPD patients in the context of COVID-19.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Progresión de la Enfermedad , Susceptibilidad a Enfermedades , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Adulto , Factores de Edad , Anciano , Comorbilidad , Infecciones por Coronavirus/terapia , Medicina Basada en la Evidencia , Humanos , Incidencia , Persona de Mediana Edad , Pandemias/estadística & datos numéricos , Neumonía Viral/terapia , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Pruebas de Función Respiratoria , Medición de Riesgo , Síndrome Respiratorio Agudo Grave/diagnóstico , Síndrome Respiratorio Agudo Grave/epidemiología , Índice de Severidad de la Enfermedad , Factores Sexuales
6.
Medicina (Kaunas) ; 56(11)2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33172013

RESUMEN

Pathogens are various organisms, such as viruses, bacteria, fungi, and protozoa, which can cause severe illnesses to their hosts. Throughout history, pathogens have accompanied human populations and caused various epidemics. One of the most significant outbreaks was the Black Death, which occurred in the 14th century and caused the death of one-third of Europe's population. Pathogens have also been studied for their use as biological warfare agents by the former Soviet Union, Japan, and the USA. Among bacteria and viruses, there are high priority agents that have a significant impact on public health. Bacillus anthracis, Francisella tularensis, Yersinia pestis, Variola virus, Filoviruses (Ebola, Marburg), Arenoviruses (Lassa), and influenza viruses are included in this group of agents. Outbreaks and infections caused by them might result in social disruption and panic, which is why special operations are needed for public health preparedness. Antibiotic-resistant bacteria that significantly impede treatment and recovery of patients are also valid threats. Furthermore, recent events related to the massive spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are an example of how virus-induced diseases cannot be ignored. The impact of outbreaks, such as SARS-CoV-2, have had far-reaching consequences beyond public health. The economic losses due to lockdowns are difficult to estimate, but it would take years to restore countries to pre-outbreak status. For countries affected by the 2019 coronavirus disease (COVID-19), their health systems have been overwhelmed, resulting in an increase in the mortality rate caused by diseases or injuries. Furthermore, outbreaks, such as SARS-CoV-2, will induce serious, wide-ranging (and possibly long-lasting) psychological problems among, not only health workers, but ordinary citizens (this is due to isolation, quarantine, etc.). The aim of this paper is to present the most dangerous pathogens, as well as general characterizations, mechanisms of action, and treatments.


Asunto(s)
Infecciones por Coronavirus , Infecciones , Pandemias , Neumonía Viral , Salud Pública , Betacoronavirus , Guerra Biológica/métodos , Guerra Biológica/prevención & control , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/terapia , Humanos , Infecciones/epidemiología , Infecciones/microbiología , Infecciones/terapia , Pandemias/economía , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Neumonía Viral/terapia , Psicología
7.
Can J Surg ; 63(6): E527-E529, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33180692

RESUMEN

SUMMARY: The cancellation of large numbers of surgical procedures because of the coronavirus disease 2019 (COVID-19) pandemic has drastically extended wait lists and negatively affected patient care and experience. As many facilities resume clinical work owing to the currently low burden of disease in our community, we are faced with operative booking protocols and procedures that are not mathematically designed to optimize efficiency. Using a subset of artificial intelligence called "machine learning," we have shown how the use of operating time can be optimized with a custom Python (a high-level programming language) script and an open source machine-learning algorithm, the ORTools software suite from the Google AI division of Alphabet Inc. This allowed the creation of customized models to optimize the efficiency of operating room booking times, which resulted in a reduction in nursing overtime of 21% - a theoretical cost savings of $469 000 over 3 years.


Asunto(s)
Citas y Horarios , Infecciones por Coronavirus/prevención & control , Eficiencia Organizacional/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Aprendizaje Automático , Quirófanos/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Ontario , Tempo Operativo , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología
8.
Saudi Med J ; 41(11): 1197-1203, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33130839

RESUMEN

OBJECTIVES: To investigate whether the coronavirus disease-2019 pandemic has had any effects on pediatric vaccination rates at the main university hospital in Saudi Arabia. METHODS: A retrospective study conducted at King Saud University Medical City, Riyadh, Saudi Arabia using electronic health records. The vaccination statuses of all children who were scheduled for vaccinations at birth and at 2, 4, 6, 9, and 12 months during March, April and May between 2017 and 2020 were included in the study with total sample of 15,870 children, and comparisons between the cohorts were performed. RESULTS: All vaccination visits during April and May 2020 were below the lower extremes except for the birth vaccinations. In March, April, and May 2020 there were respective drops in vaccination visits of 49.93%, 71.90% and 68.48% compared with the mean numbers of vaccination visits during the same months from 2017 to 2019. In comparisons of mean numbers of visits from March 2017 to May 2019 and March to May in 2020, the respective reductions in visits for birth and 2, 4, 6, 9 and 12-month vaccinations were 16.5%, 80.5%, 74.7%, 72.9%, 80.0% and 74.1%. CONCLUSIONS: The huge impact of the coronavirus disease-2019 pandemic on childhood vaccinations will require urgent vaccination recovery plans with innovative approaches and future action plans to maintain vaccination coverage during any subsequent pandemics.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Inmunización/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Factores de Edad , Preescolar , Estudios de Cohortes , Femenino , Hospitales Universitarios , Humanos , Inmunización/métodos , Incidencia , Lactante , Recién Nacido , Masculino , Pandemias/estadística & datos numéricos , Estudios Retrospectivos , Arabia Saudita/epidemiología , Factores Sexuales
9.
Saudi Med J ; 41(11): 1204-1210, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33130840

RESUMEN

OBJECTIVES: To evaluate acute cardiac injury in COVID-19 patients and its association with adverse outcomes including mortality in the United Arab Emirates (UAE) population. METHODS: A retrospective study conducted between February and June 2020 in Dubai, UAE, for all laboratory-confirmed Coronavirus disease-19 patients. Demographic, clinical, laboratory, radiological, and clinical outcomes were compared between patients with and without acute cardiac injury. RESULTS: During the study period, 203 patients were included, of which, 44 (21.7%) had evidence of acute cardiac injury. Compared with patients without acute cardiac injury, patients with acute cardiac injury were: older, had more shortness of breath, diabetes, hypertension, and more bilateral airspace shadowing on admission chest radiography. These patients also had a higher neutrophil count, C-reactive protein, procalcitonin, ferritin, D-dimers and lactate dehydrogenase but lower lymphocyte count. Regarding outcomes, these patients had higher intensive care admissions; a higher rate of complications including acute kidney and liver injury, acidosis, septic shock, acute respiratory distress syndrome, needed more mechanical ventilation, and had a significantly higher risk of death. CONCLUSION: Acute cardiac injury is common among Coronavirus disease-19 patients. These patients present with higher comorbidities, have high inflammatory markers and have greater risk for in-hospital multi-organ damage, need for mechanical ventilation, and death. Prompt full assessment and intervention are recommended.


Asunto(s)
Causas de Muerte , Infecciones por Coronavirus/epidemiología , Lesiones Cardíacas/epidemiología , Mortalidad Hospitalaria/tendencias , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Enfermedad Aguda , Adulto , Anciano , Estudios de Cohortes , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Femenino , Lesiones Cardíacas/diagnóstico , Hospitalización/estadística & datos numéricos , Hospitales Urbanos , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Estudios Retrospectivos , Arabia Saudita/epidemiología , Índice de Severidad de la Enfermedad , Tasa de Supervivencia
10.
Saudi Med J ; 41(11): 1211-1216, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33130841

RESUMEN

OBJECTIVES: To study the impact of curfews during the COVID-19 pandemic, on the physical activity in patients of heart failure implanted withcardiac implantable electronic devices (CIEDs). METHODS: This was a retrospective single-center study of heart failure patients inserted with remote monitoring (RM)-capable CIED. We analyzed the transmitted data of physical activity and fluid volume status of all patients, before, and during the lockdown periods between February and April 2020. The clinical status of the patients was also evaluated.  Results: Device data from 429 patients implanted with CIED capable of RM were initially evaluated. Patients with an implantable loop recorder, Brugada or Long QT syndromes, and patients with incomplete transmissions were excluded. Eighty-two patients with heart failure were included. The median age was 65 years (58-72), and 53 (64.6%) subjects were men. There was a 27.1% decline in physical activity, and the median physical activity of patients significantly declined from 2.4 to 1.8 hours/day (p=0.000010).  Conclusion: Data obtained by remotely monitored CIED in heart failure patients suggests a significant decline in physical activity during the country lockdown due to the pandemic. Awareness of the future potential hazards in this group of patients is warranted.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Desfibriladores Implantables/estadística & datos numéricos , Ejercicio Físico/fisiología , Insuficiencia Cardíaca/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Cuarentena/estadística & datos numéricos , Telemetría/métodos , Anciano , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Femenino , Insuficiencia Cardíaca/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Pronóstico , Cuarentena/métodos , Estudios Retrospectivos , Medición de Riesgo , Arabia Saudita , Conducta Sedentaria , Tasa de Supervivencia
11.
Saudi Med J ; 41(11): 1217-1226, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33130842

RESUMEN

OBJECTIVES: To provide a detailed study of demographic, baseline comorbidities, clinical features, and outcome for Coronavirus disease 2019 (COVID-19) patients. METHODS: A record-based case-series study conducted from March 23 to June 15, 2020 in King Saud Medical City, Riyadh, Saudi Arabia. Demographic data, clinical presentation, laboratory investigations, complications, and in-hospital outcome of COVID-19 patients collected with analysis of the clinical characteristics for survivors and deceased. RESULTS: A total of 768 patients were included. The mean age was 46.36±13.7 years and 76.7% were men. Approximately 96.3% reported more than one comorbidity; diabetes mellitus was the most frequent (46.4%). Fever (84.5%), cough (82.3%), and shortness of breath (79.8%) were the main presenting symptoms. During the follow-up, pneumonia reported in 68.6%, acute respiratory distress syndrome in 32.7%, septic shock in 20.7%, respiratory failure in 20.3%, and acute kidney injury in 19.3%. Approximately 45.8% of enrolled patients required intensive care unit admission. Lung disease (odd ratio [OR]=3.862 with 95% confident interval [CI] (2.455-6.074), obesity (OR=3.732, CI=2.511-5.546), smoking (OR=2.991, CI=2.072-4.317), chronic kidney disease (OR=2.296. CI=1.497-3.521), and diabetes mellitus (OR=2.291, CI=1.714-3.063) are predictors of ICU admission. Fatality ratio was 4.27%; therefore, men were more prevalent in dead group. CONCLUSION: Coronavirus disease 2019 places a huge burden on healthcare facilities, particularly in patients with comorbidity. Coronavirus disease 2019 patients who are obese and smokers with history of diabetes mellitus have a high risk of death.


Asunto(s)
Comorbilidad , Infecciones por Coronavirus/epidemiología , Mortalidad Hospitalaria/tendencias , Control de Infecciones/métodos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Adulto , Factores de Edad , Causas de Muerte , Estudios de Cohortes , Infecciones por Coronavirus/diagnóstico , Bases de Datos Factuales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Arabia Saudita/epidemiología , Factores Sexuales , Adulto Joven
12.
Saudi Med J ; 41(11): 1263-1269, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33130849

RESUMEN

OBJECTIVES: To assess the role of the Coronavirus Disease 2019 (COVID-19)  pandemic in improving personal hygiene in Saudi Arabia. Methods: We administered a questionnaire distributed online between 19 and 28 May 2020 to determine alterations in personal hygiene practices during this pandemic compared to the pre-pandemic phase. Results: We included 211 respondents from the Kingdom of Saudi Arabia (KSA) in this study.  Improvement at different levels was detected in all examined personal hygiene items compared to the pre-pandemic stage. The percentages of respondents who always washed their hands after coming back home (34.1%), used soap to wash their hands (58.8%), used a hand sanitizer outside (5.2%), wore a face masks while outside (1.4%) and washed their hands before preparing and/or eating food (74.9%) was increased before the pandemic to 89.6%, 90%, 63.5%, 59.2% and 89.1% during the pandemic, respectively. The percentage of respondents who never shake hands with people they know increased from 0% before the pandemic to 62.6% during the pandemic. The mean duration of washing hands with soap significantly increased from 13.31 seconds before the pandemic to 28.01 seconds during the pandemic (p less than 0.0001). CONCLUSION: The COVID-19 pandemic resulted in a noticeable improvement in the personal hygiene habits in Saudi Arabia mainly those related to COVID-19 prevention.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Desinfección de las Manos/métodos , Higiene/normas , Control de Infecciones/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adulto , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Rol , Arabia Saudita , Encuestas y Cuestionarios
14.
BMJ Case Rep ; 13(10)2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33130585

RESUMEN

Infection with SARS-CoV-2 represents a great source of concern and a new threat for immunocompromised patients. Limited studies are available on COVID-19 in immunocompromised children. This case series aimed to evaluate the clinical and laboratory characteristics, management and outcomes of COVID-19 in five children immunocompromised due to different underlying conditions. All had mild symptoms or were asymptomatic at presentation. All had a benign course of illness. No changes or delays in their treatment regimens occurred, and none experienced a relapse of the original disease, developed severe COVID-19 or died. However, these cases showed a prolonged duration of virus shedding. This report suggests that immunocompromised paediatric patients may not be at a higher risk of developing severe COVID-19. However, further studies are required to elaborate on the pathogenesis of COVID-19 in this vulnerable group.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Huésped Inmunocomprometido/inmunología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Síndrome Respiratorio Agudo Grave/diagnóstico , Factores de Edad , Niño , Preescolar , Terapia Combinada , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Pandemias/estadística & datos numéricos , Neumonía Viral/terapia , Pronóstico , Medición de Riesgo , Muestreo , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/terapia , Índice de Severidad de la Enfermedad , Factores Sexuales , Resultado del Tratamiento
15.
BMJ Case Rep ; 13(10)2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33130587

RESUMEN

A previously fit and well 37-year-old male healthcare worker presented with confusion, psychotic symptoms and a suicide attempt in the context of a new COVID-19 diagnosis. Following surgical interventions and an extended admission to the intensive care unit, he made a good recovery in terms of both his physical and mental health. A number of factors likely contributed to his presentation, including SARS-CoV-2 infection, severe insomnia, worry, healthcare worker-related stress, and the unique social and psychological stressors associated with the COVID-19 pandemic. This case highlights the need to further characterise the specific psychiatric sequelae of COVID-19 in community settings, and should remind general medical clinicians to be mindful of comorbid psychiatric symptoms when assessing patients with newly diagnosed COVID-19.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/diagnóstico , Trastornos por Estrés Postraumático/diagnóstico , Intento de Suicidio/prevención & control , Adulto , Infecciones por Coronavirus/psicología , Humanos , Masculino , Enfermeros/psicología , Estrés Laboral/complicaciones , Estrés Laboral/diagnóstico , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/psicología , Pronóstico , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/fisiopatología , Medición de Riesgo , Trastornos por Estrés Postraumático/complicaciones , Estrés Psicológico , Resultado del Tratamiento , Reino Unido
16.
BMJ Case Rep ; 13(10)2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33130588

RESUMEN

An 82-year-old man with an extensive medical history presented to the emergency room with complaints of generalised weakness and cough. He tested positive for COVID-19 10 days prior to presenting to the emergency room. Although his symptoms started a week prior to diagnosis, his weakness increased, warranting emergency response. A comprehensive metabolic panel was drawn from the patient on admission, indicating markedly high liver function tests (LFTs) ≥20 times above the upper limit of normal. On day 1 of admission, the decision was still made to start remdesivir (5-day course) due to decompensated acute respiratory failure as well as dexamethasone. The patient's LFTs significantly improved throughout his hospital stay. The patient made a full recovery and was discharged on day 10 of hospitalisation.


Asunto(s)
Adenosina Monofosfato/análogos & derivados , Alanina/análogos & derivados , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Hepatopatías/diagnóstico , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Insuficiencia Respiratoria/diagnóstico , Adenosina Monofosfato/administración & dosificación , Anciano de 80 o más Años , Alanina/administración & dosificación , Dexametasona/administración & dosificación , Servicio de Urgencia en Hospital , Humanos , Tiempo de Internación , Hepatopatías/complicaciones , Pruebas de Función Hepática , Masculino , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Alta del Paciente , Insuficiencia Respiratoria/terapia , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
17.
J Occup Health ; 62(1): e12175, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33131192

RESUMEN

OBJECTIVES: The SARS-CoV-2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and formulate recommendations for future action. METHODS: A systematic review was performed between 31st December 2019 and 17th June 2020 through Ovid Medline and Embase databases (PROSPERO ID CRD42020181204). Studies were included for review if they investigated the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and used validated psychiatric scoring tools. Prevalence of ICD-10 classified psychiatric disorders was the primary outcome measure. RESULTS: The initial search returned 436 articles. Forty-four studies were included in final analysis, with a total of 69,499 subjects. Prevalence ranges of six mental health outcomes were identified: depression 13.5%-44.7%; anxiety 12.3%-35.6%; acute stress reaction 5.2%-32.9%; post-traumatic stress disorder 7.4%-37.4%; insomnia 33.8%-36.1%; and occupational burnout 3.1%-43.0%. Direct exposure to SARS-CoV-2 patients was the most common risk factor identified for all mental health outcomes except occupational burnout. Nurses, frontline HCWs, and HCWs with low social support and fewer years of working experience reported the worst outcomes. CONCLUSION: The SARS-CoV-2 pandemic has significantly impacted the mental health of HCWs. Frontline staff demonstrate worse mental health outcomes. Hospitals should be staffed to meet service provision requirements and to mitigate the impact onmental health. This can be improved with access to rapid-response psychiatric teams and should be continually monitored throughout the pandemic and beyond its conclusion.


Asunto(s)
Agotamiento Profesional/epidemiología , Infecciones por Coronavirus/epidemiología , Personal de Salud/psicología , Salud Laboral , Estrés Laboral/epidemiología , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Infecciones por Coronavirus/prevención & control , Depresión/epidemiología , Depresión/fisiopatología , Femenino , Humanos , Masculino , Salud Mental , Pandemias/prevención & control , Neumonía Viral/prevención & control , Prevalencia , Medición de Riesgo , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Estados Unidos
18.
Methodist Debakey Cardiovasc J ; 16(3): e1-e7, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33133368

RESUMEN

Over the past decade, advances in digital trends and technology have greatly impacted the medical field with rapid delivery of and access to information. The field of cardiovascular medicine in particular has seen major technological advances and is well versed in the use of digital platforms and social media. In these unprecedented times of the COVID-19 pandemic, social media and other digital platforms are essential tools for communication, education, and delivery of information. In this review, we discuss the ways virtual learning and social media are changing medical education and research.


Asunto(s)
Cardiología/educación , Infecciones por Coronavirus/prevención & control , Educación Médica/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Medios de Comunicación Sociales/estadística & datos numéricos , Realidad Virtual , Competencia Clínica , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Aprendizaje , Masculino , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Sociedades Médicas , Estados Unidos
19.
BMC Med Educ ; 20(1): 400, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33138818

RESUMEN

BACKGROUND: COVID - 19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression. AIM OF THE WORK: This work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning. METHODS: This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole. RESULTS: Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method. CONCLUSION: In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.


Asunto(s)
Competencia Clínica , Infecciones por Coronavirus/prevención & control , Educación a Distancia/métodos , Educación a Distancia/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Estudios Transversales , Curriculum , Educación de Pregrado en Medicina/organización & administración , Femenino , Humanos , Masculino , Innovación Organizacional , Pandemias/estadística & datos numéricos , Investigación Cualitativa , Facultades de Medicina/organización & administración , Estudiantes de Medicina/psicología
20.
BMC Med Educ ; 20(1): 399, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33138810

RESUMEN

BACKGROUND: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. METHODS: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. RESULTS: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). CONCLUSIONS: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.


Asunto(s)
Competencia Clínica , Infecciones por Coronavirus/prevención & control , Odontología/organización & administración , Docentes de Odontología/organización & administración , Control de Infecciones/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Internacionalidad , Modelos Lineales , Masculino , Análisis Multivariante , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología
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